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Background In patients with syphilis,one of the common manifestations is uveitis.However,the lack of understanding on syphilic posterior uveitis may result in misdiagnosis and delayed treatment.Objective This study was to assess ocular clinical features,treatment and prognosis in patients who had latent syphilis and presented with posterior uveitis as the initial symptom.Methods A serial cases-observational study was designed.Twelve patients(19 eyes)who were diagnosed as syphilis from September 2011 to January 2013 were retrospectively analyzed.All patients were characterized by initial posterior uveitis before the final diagnosis.The clinical manifestation,management and prognosis were evaluated and analyzed.All patients were informed of this study and consented with the use of their data for this retrospective study.Results The patients presented with initial clinical signs of acute or chronic posterior uveitis and lacked systemic syphilis symptom.Bilateral posterior uveitis were found in 7 patients and unilateral in 5 patients.The dust-like and grey-white opacification in vitreous was seen by threemirror contact lens in all the patients.Mild hyperemia of the optical disc was found in 10 eyes with the unclear peripapillary boundary.Yellow-white lesions were observed in retinas of 7 eyes and retinal punctuate hemorrhage was in 1 eye.Fundus fluorescein angiography demonstrated fluorescine staining or hyperfluorescence of optic disc in all of the 19 eyes,and fluorescein leakage from vein in 18 eyes,retinal pigment epithelium dye pooling in 6 eyes and cystoid macular edema in 11 eyes.Rapid plasma reagin (RPR) test and treponema pallidum hemagglutination assay (TPHA) were performed and presented positive results in all patients.The visual acuity improved in 19 eyes and partly elevated in 2 eyes following a standard therapy for neurosyphilis was used,including penicillin and/or small doses of glucocorticoid.Conclusions The serological examination for syphilis should be considered for patients with unexplained uveitis.Early diagnosis and prompt treatment are important for the improvement of prognosis in syphilitic posterior uveitis.
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@#Objective To investigate the clinical features, therapeutic strategy and prognosis of pediatric benign cerebellar astrocytomas (BCAs). Methods 101 children with BCAs diagnosed histopathologically were analyzed retrospectively and followed up. Results There were 50 boys and 51 girls with a median age of 9.8 years old. The sizes of tumors were 3～7.5 cm. 46 cases were with solid-tumor, 24 with the tumor in the cyst, 31 with the cysty in the tumor. 39 cases were located in cerebellum vermis, 58 cases were in the cerebellar hemisphere and 9 cases were adhesive with brain stem located in the forth ventricle. 92 cases were total removed and 9 cases were subtotal removed. 87 patients were followed up for 1～5 years, and all of them has survived, without radiotherapy or chemotherapy. Conclusion Pediatric benign cerebellar astrocytomas mostly grows in cerebellar hemisphere， also in vermis frequently. Neuroimaging and pathology may conduce to the diagnosis. Microsurgical resection may result in optimal outcome.
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@#Objective To discuss the clinical characteristics, treatment and prognosis of pseudotumor forms of demyelinating diseases. Methods 21 patients with pseudotumor forms of demyelinating diseases diagnosed pathologically were analyzed retrospectively. Results 16 cases were operated on. The lesions were established through biopsy in other 5 patients. All the patients improved significantly after corticosteroid therapy. 4 patients relapsed after treatment, and 1 patient died. Conclusion The feature of pseudotumor forms of demyelinating disease is similar to some kinds of intracranial tumors, however it presents some radiological characteristics. Diagnostic corticoid therapy may be helpful to draw a diagnosis.
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Objective To present and summarize the data concerning the treatment and prognosis of acute limb arterial embolism in West China Hospital.Methods Forty three patients with 52 limbs of acute arterial embolism were treated in West China Hospital from January 2003 to March 2006.There were 15 males and 28 females,aging from 26 years to 77 years 〔(58.88?13.90) years〕.The diagnosis was based on clinical manifestations and results of color Doppler sonography or DSA.The follow-up ranged from 1 month to 39 months.The following factors,which might influence the prognosis,were analysed through multiple linear regression of SPSS 10.0:age,sex,uper limb or lower limb,location of embolus,ischemic time,clinical categories of acute limb ischemia,history of smoking,atherosclerosis and other combined diseases,pervious history of acute limb arterial embolism,operative or nonoperative treatment,and postoperative complications.Results Clinical categories of acute limb ischemia include:Ⅰ(n=0),Ⅱa(n=16),Ⅱb(n=29),Ⅲ(n=7).The ischemic time varied from 3 h to 2 weeks.The sources of embolus:heart(n=39),vessle(n=7),iatrogenic origin(n=1),unidentidied origin(n=5).The therapies included embolectomy(n=38),catheter-directed thrombolysis(n=2) and medical treatment(n=12).The following postoperative complications occured:compartment syndrome(n=12),respiratory failure(n=3),alkalolsis(n=3),acute renal failure(n=2),wound infection(n=2) and pulmonary infection(n=1).Two patients died of cerebral infarction in hospital and one patient died of heart failure 3 months after discharge.Thirty-eight patients with 45 diseased limbs were followed up.The results were excellent in 13 limbs,good in 15 ones,fair in 8 ones and poor in 9 ones.The statistically significant influencing factors of prognosis include ischemic time,clinical categories of acute limb ischemia and history of smoking(P
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@#ObjectiveTo observe the therapeutic effect and prognosis of nimodipine on severe traumatic brain injury. Methods64 patients with severe traumatic brain injury were divided into the nimodipine group(32 cases) and the routine treatment group(32 cases). The Glasgow Coma Scale(GCS) was assessed before and after the treatment. The Activities of Daily Living(ADL) and cognitive ability were evaluated in clear-headed patients. After 6 months follow-up, the Glasgow Outcome Scale (GOS), Bathel index and Mini Mental State Examination (MMSE) score were carried on.ResultsIn both of the two groups, GCS score were increased distinctively after treatment. The MMSE score in nimodipine group was higher than that of routine treatment group. There was no statistic difference in GOS and ADL between two groups after 6 months, but MMSE in nimodipine group was higher than that of routine treatment group. Conclusions Nimodipine could be helpful in cognitive function. The prognosis of severe traumatic brain injury lied on the degree of cerebral damage.
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@#ObjectiveTo study the mechanisms and related factors and preventive managements of the stress ulcer complicating with acute cervical spinal cord injury. MethodsThe clinical findings of eight cases of the acute cervical spinal cord injury with stress ulcer were reviewed retrospectively.ResultsFive cases were cured by conservative treatment, one case was cured after operations, two cases died of breath and circulation failure.ConclusionStress ulcer is a critical complication of acute cervical spinal cord injury. It should be prevented actively.
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OBJECTIVE: The goal of this study was to examine whether MMPI scores could discriminate between normal group and exaggerated pain group and predict treatment prognosis in exaggerated pain group. METHODS: For psychological evaluation, MMPI was administered to 37 low back pain patients and 36 normal controls. MMPI findings in two groups were compared, using t-test and discriminant function analysis. Nineteen patients of exaggerated low back pain group contacted by telephone were questioned about treatment satisfaction degree. And satisfaction group(9 patients)nd dissatisfaction group(6 patients)s MMPI findings were compared. RESULT: Hy, Hs, D scale scores in exaggerated pain group were higher than in control group. In discriminant function analysis by Hs, Hy, and D, percent of correctly classified 'gouped' cases was 74%. Discriminant function of Hy scale was the highest and that of D scale was the lowest. In satisfaction degree study, no finding was significant. CONCLUSION: MMPI findings were effective in discriminating between exaggerated pain group and normal control group. Further researches will need more structured and comprehensive approach.